Neuro Flashcards
Crescendo TIA def
Two or more TIAs in a week
Recognition of stroke in ED tool
ROSIER
Initial management of TIA
Aspirin 300mg daily
Referred to specialist to be seen within 24hrs
Secondary prevention of stroke
Clopidogrel Atorvastatin Carotid endarterectomy (when appropriate)
Who gets MS and when does it present
Women under 50 classically
Symptoms improve in pregnancy and postpartum
CNS or PNS affected in MS
CNS
Classic presentation of symptoms in MS
Last for weeks then improve
Common MS signs/ symptoms
Optic neuritis (LR6 lesion)
Focal weakness
Focal sensory symptoms
Ataxia
What is Lhermitte’s sign
Electric shock sensation that travels down spine when stretching DCML
Disease patterns in MS
Clinically isolated syndrome - first episode of demyelination
Relapsing remitting - episodes of disease followed by recovery
Secondary progressive - worsening now with incomplete remissions
How to diagnose MS
MRI scan
Lumbar puncture shot oligoclonal bands
How does optic neuritis present
Unilateral reduced vision developing over hours to days. Pain on movement. RAPD. Impaired colour vision. Central scotoma (enlarged blind spot)
MS drug to treat relapses
500mg methylpred 5 days
How does MND affect sensory neurones
It does not
Most common type of MND
ALS
Amyotrophic lateral sclerosis
Typical person to get MND
60M
Typical MND presentation
60M with progressive weakness of muscles. Often worse in upper limbs. Clumsiness.
Triad of Parkinsons
Resting tremor, rigidity and bradykinesia
Does MND affect UMN or LMN
Both
Does a PD tremor improve with rest
No
Worse at rest
Does a PD tremor improve with ETOH
No
Is a PD tremor symmetrical
No
Main PD treatment
Levodopa
What is entacapone
A PD drug - COMT inhibitor.
Epilepsy definition
Tendency to have seizures
First and second line treatments for tonic clonic seizure
1: sodium valproate
2: lamotrigine or carbamazepine
Where do focal seizures start
Temporal lobe
What do focal seizures affect
Hearing, speech, memory and emotions
May present as hallucinations, flashbacks, deja vu, strange things on autopilot
First line management of local seizures
Carbamazepine or lamotrigine
First line treatment for absence seizures (2)
Sodium valproate
Ethosuximide
